Lower back pain can be treated with ‘talking therapy’

18 June, 2015 | By Jo Stephenson


An innovative form of talking therapy could help people suffering from chronic lower back pain, according to new research.

A study testing the use of contextual cognitive behavioural therapy (CCBT), which focuses on helping people live life to the full despite ongoing pain, found participants valued the approach.

“Combining physical and psychological approaches could be the way forward to treat this common, often disabling condition more effectively”

Stephen Simpson

But both patients and clinicians involved in the research by Royal Holloway, University of London, said they would prefer a combination of both talking therapy and physiotherapy.

Lower back pain is one of the most common health problems in the UK and affects many nurses. As well as enduring physical pain, many sufferers also experience related psychological distress.

The study, published online in the journal BMC Musculoskeletal Disorders and funded by Arthritis Research UK, set out to test whether CCBT could be a credible and acceptable treatment.

It involved 89 people with lower back pain and high levels of psychological distress who tended to avoid everyday activities.

Participants were chosen at random to receive either one-to-one CCBT delivered by trained psychologists or physiotherapy group exercise sessions.

“Interestingly, many patients who took part, as well as several of the clinicians involved thought the best treatment was a combination of both physiotherapy and CCBT,” said Professor Tamar Pincus from Royal Holloway’s department of psychology.

“Patients and clinicians felt the best solution would be to deal with both physical and psychological problems,” she said.

Another key finding was the fact patients preferred the idea of one-to-one talking therapy as opposed to group sessions.

“We know that for some people with chronic lower back pain psychological distress is a major factor and therefore there is a significant challenge to find effective treatments,” added Stephen Simpson, director of research and programmes at Arthritis UK.

“This study has shown that combining physical and psychological approaches could be the way forward to treat this common, often disabling condition more effectively,” he said.

Professor Pincus and her team are now planning a larger clinical trial to explore whether a combination of physiotherapy and psychology can help improve outcomes for patients and reduce long-term treatment costs.

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